Chronic deep brain stimulation (DBS) has been a rapidly evolving area of neurotherapeutics since its initial introduction for the treatment of Parkinson's disease and essential tremor in the 1990s. For these conditions, DBS is now considered accepted therapy for patients failing to adequately respond to m- ical treatment. Since the 1990s, new clinical indications, anatomic targets, and technologies have contributed to an expanding role for DBS in the treatment of other movement disorders such as dystonia and Tourette syndrome as well as for other neurologic disorders such as epilepsy and cluster headache. Early experience has also been reported for psychiatric syndromes, such as obs- sivecompulsive disorder and depression. Experience with DBS in psychiatric disorders is very limited but is reviewed in this volume as neuropsychiatric indications are expected to grow in coming years. Because of the rapidly increasing application of DBS for neurologic and psychiatric indications and the recruitment of increasing numbers of neu- logic, neurosurgical, and psychiatric clinicians to the field, it is appropriate to provide a resource that updates the underlying scientific background, describes methodologies and standards of treatment, and provides information on new technologies essential for clinical success and to advance the field. Deep Brain Stimulation in Neurological and Psychiatric Disorders begins with reviews of the functional anatomy and physiology of motor and nonmotor aspects of the basal ganglia and their connections, which underlie the application of DBS to neurological and psychiatric disorders.

State-of-the-art, comprehensive, and balanced overview of DBS by renowned authorities in the field Reviews functional anatomy and physiology of motor and nonmotor aspects of the basal ganglia and connections which underlie the application of DBS Examines proposed mechanisms of action of DBS based on functional neuroimaging and neurophysiologic studies in animals and man Offers guidance on patient selection, preoperative assessment, operative complications, and brain targeting Discusses microelectrode mapping as well as new and emerging brain imaging alternatives for target localization inside the operating room Includes discussion of postoperative management and outcomes, as well as immediate and delayed complications Provides novel and vital chapters on programming, DBS safety with regard to MRI and other electronic devices, neuropsychological sequelae, and quality of life Addresses new areas of DBS application by experts in Tourette syndrome, epilepsy, obsessive-compulsive disorder, depression, and cluster headache

Klappentext

Written by renowned authorities in the field, Deep Brain Stimulation in Neurological and Psychiatric Disorders discusses today's most current and cutting-edge applications of DBS. Initially used to treat Parkinson's disease and essential tremor, DBS now has new clinical indications, new anatomic targets, and new technologies that enable an expanded role for DBS in the treatment of other movement disorders such as dystonia, and for other neurologic disorders such as epilepsy, Tourette syndrome and cluster headache. Early experience has also been reported for psychiatric syndromes, such as obsessive-compulsive disorder and depression. This important book begins with reviews of the functional anatomy and physiology of motor and nonmotor aspects of the basal ganglia and their connections which underlie the application of DBS to neurological and psychiatric disorders. This is followed by proposed mechanisms of action of DBS based on functional neuroimaging and neurophysiologic studies in animals and man. Discussions of patient selection, preoperative assessment, operative complications and brain targeting are followed by chapters concerning the demands of microelectrode mapping as well as new and emerging brain imaging approaches for target localization inside the operating room. Postoperative management and outcomes are reviewed in a series of chapters concerning immediate and delayed complications. Particularly important chapters on programming, DBS safety with regard to MRI and other electronic devices, neuropsychological sequelae, and quality of life are also included. Finally, new areas of DBS application are addressed by experts with experience in Tourette syndrome, epilepsy, obsessive-compulsive disorder, depression, and cluster headache. Comprehensive and state-of-the-art, Deep Brain Stimulation in Neurological and Psychiatric Disorders provides a balanced and level-headed approach to the use of DBS with emphasis on proper andobjective assessment of outcomes, particularly in regard to the new and emerging applications -- all with the main goal of providing patients with some measure of relief from their difficult conditions.

Inhalt
Overview of Deep Brain Stimulation.- Functional Anatomy and Physiology of the Basal Ganglia: Motor Functions.- Functional Anatomy and Physiology of the Basal Ganglia: Non-motor Functions.- History of the Therapeutic Use of Electricity on the Brain and the Development of Deep Brain Stimulation.- Deep Brain Stimulation: Patient Selection in Parkinson's Disease, Other Movement Disorders, and Neuropsychiatric Disorders.- Technical Alternatives in Performing Deep Brain Stimulator Implantation.- Intra-operative Microrecording and Stimulation.- Complication Avoidance and Management in Deep Brain Stimulation Surgery.- Mechanisms of Deep Brain Stimulation.- Functional Imaging of Deep Brain Stimulation: fMRI, SPECT, and PET.- Deep Brain Stimulation in Movement Disorders.- Thalamic Deep Brain Stimulation and Essential Tremor.- Thalamic Deep Brain Stimulation for Other Tremors.- Thalamic Deep Brain Stimulation for Parkinson's Disease Tremor.- Globus Pallidus Deep Brain Stimulation for Parkinson's Disease.- Deep Brain Stimulation of the Subthalamic Nucleus for the Treatment of Parkinson's Disease.- Deep Brain Stimulation of the Globus Pallidus Pars Interna and Subthalamic Nucleus in Parkinson's Disease: Pros and Cons.- Deep Brain Stimulation in Atypical Parkinsonism.- Deep Brain Stimulation in Dystonia.- Deep Brain Stimulation in Tourette's Syndrome.- The Role of Deep Brain Stimulation (DBS) in the Treatment of Postural Instability and Gait Disorders of Parkinson's Disease.- Postoperative Management in Patients Undergoing Deep Brain Stimulation.- Deep Brain Stimulation Programming for Movement Disorders.- Neuropsychological Issues in Deep Brain Stimulation of Neurological and Psychiatric Disorders.- Deep Brain Stimulation Safety: MRI and Other Electromagnetic Interactions.- Deep Brain Stimulation Fault Testing.- Quality of Life and Cost Effectiveness of Deep Brain Stimulation in Movement Disorders.- Deep Brain Stimulation in Other Indications.- Deep Brain Stimulation in Depression: Background, Progress, and Key Issues.- Deep Brain Stimulation in Obsessive-Compulsive Disorder.- Deep Brain Stimulation for Medically Intractable Cluster Headache.- Deep Brain Stimulation in Epilepsy.- The Future of Deep Brain Stimulation.